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Renate Huch - One of the best experts on this subject based on the ideXlab platform.
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response of pregnancy leg Edema to a single immersion exercise session
Obstetrical & Gynecological Survey, 2006Co-Authors: Sabine Hartmann, Renate HuchAbstract:Dependent leg Edema is not uncommon in pregnant women and may cause pain with each step. In addition to compression stockings and leg elevation, immersing the extremities in water is beneficial. This prospective trial evaluated a single session of immersion exercise in 9 women 32 to 36 years of age who had marked Edema but otherwise uncomplicated pregnancies at 25 to 39 weeks gestation. Only one of the women was parous. A few hours after the midday meal, the women had a 45-minute session of upright water immersion exercise. A vest, worn like a backpack, kept the wearer afloat and immersed to the axilla without the need for extremity movements. After warming up for 5 minutes, the women performed coordination exercises for 10 minutes and a range of running sequences for 30 minutes. Lower leg volume was measured in triplicate by the displacement method using a polyurethane vessel with an overflow device. Supine lower leg circumference also was measured before and after immersion exercise. A single session decreased the volume of both legs by an average of 6.3% on the left and 4.9% on the right. Lower leg circumference decreased significantly on both sides. Maternal heart rate did not change significantly after immersion exercise, but during the session, the rate increased by 15 beats per minute on average. Systolic blood pressure increased significantly 1 minute after exercise, from 124 to 130 mm Hg, and nearly significantly after 5 minutes. Diastolic blood pressure, however, remained unchanged. The women felt very positively about the beneficial effects of immersion exercise on leg Edema. A single 45-minute session of immersion exercise effectively-and safely-improved marked lower leg Edema in these women. This form of exercise could complement or supplant the use of compression stockings as a means of reducing Dependent Edema in pregnant women.
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response of pregnancy leg Edema to a single immersion exercise session
Acta Obstetricia et Gynecologica Scandinavica, 2005Co-Authors: Sabine Hartmann, Renate HuchAbstract:Background. To quantify the effect of a single immersion exercise session on uncomplicated Dependent Edema in pregnancy. Methods. Lower leg volume was measured by water displacement volumetry and limb circumference in nine women with marked Dependent Edema, but otherwise normal second or third trimester pregnancy, before and after upright water immersion exercise session (Aqua-Fit ® ) for 45 min. Maternal heart rate was monitored continuously throughout the session. Blood pressure was measured before and after the session. Results. Mean left leg volume decreased by 112 ml from 1665 to 1553 ml, and right leg volume by 84 ml from 1665 to 1581 ml ( P = 0.007). Cardiovascular parameters fluctuated within the normal range, well below the upper limits recommended in pregnancy. Conclusions. A single immersion exercise session is a safe, effective, and enjoyable complement, or alternative, to compression stockings for reduction of gestational Dependent Edema. Further study is required to determine its duration of...
Marco Guazzi - One of the best experts on this subject based on the ideXlab platform.
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body fluid withdrawal with isolated ultrafiltration effects persistent improvement of functional capacity in patients with chronic congestive heart failure furosemide does not produce the same result
Cardiologia (Rome Italy), 1994Co-Authors: Giancarlo Marenzi, Paolo Sganzerla, Guilio Lauri, Giovanni B. Perego, Marco Guazzi, Piergiuseppe AgostoniAbstract:In moderate congestive heart failure pulmonary overhydration may be detected at chest X-ray even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of overhydration of the lung may help to define its significance. This study was aimed at investigating whether a subclinical accumulation of fluid in the lung interstitium in moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide is able to promote reabsorption of the excessive fluid. Patients whose digoxin, oral furosemide and ACE-inhibitor therapeutic regimen was kept constant, were randomly allocated to ultrafiltration (8 cases) or iv bolus (mean dose = 248 mg) of supplemental furosemide (8 cases). The amount of body fluid removed with each method approximated 1.600 ml. Functional performance was assessed with cardiopulmonary exercise tests. Soon after fluid withdrawal with either procedure the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine and aldosterone were augmented. After furosemide hormones remained elevated in the subsequent 4 days, and, during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, recurrence of lung congestion without any improvement in functional capacity. In ultrafiltrated patients, renin, norepinephrine and aldosterone fell below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). Functional capacity in these patients was improved through favorable circulatory and ventilatory adjustments consequent on reabsorption of lung water. This may also have restored the ability of the lung to clear norepinephrine, thus restraining its facilitation of renin release. Improvement persisted at 3 months after the procedure. In congestive heart failure the set point of fluid balance is altered despite oral furosemide; supplemental iv furosemide does not shift the set point, at least in the presence of ACE-inhibition; excessive, although silent, lung water limits the functional capacity of the patient.
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sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency failure of furosemide to provide the same result
The American Journal of Medicine, 1994Co-Authors: Piergiuseppe Agostoni, Paolo Sganzerla, Giancarlo Marenzi, Gianfranco Lauri, Giovanbattista Perego, Maurizio Schianni, Marco GuazziAbstract:Abstract objectives: This study was designed to investigate whether a subclinical accumulation of fluid in the lung interstitium associated with moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide treatment can promote reabsorption of the excessive fluid. background: In patients with moderate congestive heart failure, pulmonary overhydration may be detected by chest roentgenography even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of the overhydration may help define its significance. methods: Patients, whose regimens of digoxin, oral furosemide, and angiotensin-converting enzyme (ACE) inhibitor therapy were kept constant, were randomly allocated to receive ultrafiltration (8 cases) or an intravenous bolus of supplemental furosemide (mean dose: 248 mg; 8 cases). The amount of body fluid removed with each method approximated 1600 mL. Functional performance was assessed with cardiopulmonary exercise tests. results: Soon after fluid withdrawal by either method, the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine, and aldosterone were augmented. After furosemide administration, hormone levels remained elevated for the next 4 days, and during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, and reoccurrence of lung congestion with no improvement in functional capacity. After ultrafiltration, levels of renin, norepinephrine, and aldosterone fell to below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). The favorable circulatory and ventilatory adjustments consequent to the reabsorption of lung water improved the functional capacity of these patients. That may also have restored the lung's ability to clear norepinephrine, thus restraining its facilitation of renin release. The improvement continued 3 months after the procedure. conclusions: In patients with congestive heart failure the set point of fluid balance is altered in spite of oral furosemide therapy; supplemental intravenous furosemide does not shift the set point, at least not when combined with ACE inhibition. Excessive, although asymptomatic, lung water limits the functional capacity of the patient.
Piergiuseppe Agostoni - One of the best experts on this subject based on the ideXlab platform.
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body fluid withdrawal with isolated ultrafiltration effects persistent improvement of functional capacity in patients with chronic congestive heart failure furosemide does not produce the same result
Cardiologia (Rome Italy), 1994Co-Authors: Giancarlo Marenzi, Paolo Sganzerla, Guilio Lauri, Giovanni B. Perego, Marco Guazzi, Piergiuseppe AgostoniAbstract:In moderate congestive heart failure pulmonary overhydration may be detected at chest X-ray even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of overhydration of the lung may help to define its significance. This study was aimed at investigating whether a subclinical accumulation of fluid in the lung interstitium in moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide is able to promote reabsorption of the excessive fluid. Patients whose digoxin, oral furosemide and ACE-inhibitor therapeutic regimen was kept constant, were randomly allocated to ultrafiltration (8 cases) or iv bolus (mean dose = 248 mg) of supplemental furosemide (8 cases). The amount of body fluid removed with each method approximated 1.600 ml. Functional performance was assessed with cardiopulmonary exercise tests. Soon after fluid withdrawal with either procedure the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine and aldosterone were augmented. After furosemide hormones remained elevated in the subsequent 4 days, and, during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, recurrence of lung congestion without any improvement in functional capacity. In ultrafiltrated patients, renin, norepinephrine and aldosterone fell below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). Functional capacity in these patients was improved through favorable circulatory and ventilatory adjustments consequent on reabsorption of lung water. This may also have restored the ability of the lung to clear norepinephrine, thus restraining its facilitation of renin release. Improvement persisted at 3 months after the procedure. In congestive heart failure the set point of fluid balance is altered despite oral furosemide; supplemental iv furosemide does not shift the set point, at least in the presence of ACE-inhibition; excessive, although silent, lung water limits the functional capacity of the patient.
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sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency failure of furosemide to provide the same result
The American Journal of Medicine, 1994Co-Authors: Piergiuseppe Agostoni, Paolo Sganzerla, Giancarlo Marenzi, Gianfranco Lauri, Giovanbattista Perego, Maurizio Schianni, Marco GuazziAbstract:Abstract objectives: This study was designed to investigate whether a subclinical accumulation of fluid in the lung interstitium associated with moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide treatment can promote reabsorption of the excessive fluid. background: In patients with moderate congestive heart failure, pulmonary overhydration may be detected by chest roentgenography even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of the overhydration may help define its significance. methods: Patients, whose regimens of digoxin, oral furosemide, and angiotensin-converting enzyme (ACE) inhibitor therapy were kept constant, were randomly allocated to receive ultrafiltration (8 cases) or an intravenous bolus of supplemental furosemide (mean dose: 248 mg; 8 cases). The amount of body fluid removed with each method approximated 1600 mL. Functional performance was assessed with cardiopulmonary exercise tests. results: Soon after fluid withdrawal by either method, the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine, and aldosterone were augmented. After furosemide administration, hormone levels remained elevated for the next 4 days, and during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, and reoccurrence of lung congestion with no improvement in functional capacity. After ultrafiltration, levels of renin, norepinephrine, and aldosterone fell to below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). The favorable circulatory and ventilatory adjustments consequent to the reabsorption of lung water improved the functional capacity of these patients. That may also have restored the lung's ability to clear norepinephrine, thus restraining its facilitation of renin release. The improvement continued 3 months after the procedure. conclusions: In patients with congestive heart failure the set point of fluid balance is altered in spite of oral furosemide therapy; supplemental intravenous furosemide does not shift the set point, at least not when combined with ACE inhibition. Excessive, although asymptomatic, lung water limits the functional capacity of the patient.
Sabine Hartmann - One of the best experts on this subject based on the ideXlab platform.
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response of pregnancy leg Edema to a single immersion exercise session
Obstetrical & Gynecological Survey, 2006Co-Authors: Sabine Hartmann, Renate HuchAbstract:Dependent leg Edema is not uncommon in pregnant women and may cause pain with each step. In addition to compression stockings and leg elevation, immersing the extremities in water is beneficial. This prospective trial evaluated a single session of immersion exercise in 9 women 32 to 36 years of age who had marked Edema but otherwise uncomplicated pregnancies at 25 to 39 weeks gestation. Only one of the women was parous. A few hours after the midday meal, the women had a 45-minute session of upright water immersion exercise. A vest, worn like a backpack, kept the wearer afloat and immersed to the axilla without the need for extremity movements. After warming up for 5 minutes, the women performed coordination exercises for 10 minutes and a range of running sequences for 30 minutes. Lower leg volume was measured in triplicate by the displacement method using a polyurethane vessel with an overflow device. Supine lower leg circumference also was measured before and after immersion exercise. A single session decreased the volume of both legs by an average of 6.3% on the left and 4.9% on the right. Lower leg circumference decreased significantly on both sides. Maternal heart rate did not change significantly after immersion exercise, but during the session, the rate increased by 15 beats per minute on average. Systolic blood pressure increased significantly 1 minute after exercise, from 124 to 130 mm Hg, and nearly significantly after 5 minutes. Diastolic blood pressure, however, remained unchanged. The women felt very positively about the beneficial effects of immersion exercise on leg Edema. A single 45-minute session of immersion exercise effectively-and safely-improved marked lower leg Edema in these women. This form of exercise could complement or supplant the use of compression stockings as a means of reducing Dependent Edema in pregnant women.
-
response of pregnancy leg Edema to a single immersion exercise session
Acta Obstetricia et Gynecologica Scandinavica, 2005Co-Authors: Sabine Hartmann, Renate HuchAbstract:Background. To quantify the effect of a single immersion exercise session on uncomplicated Dependent Edema in pregnancy. Methods. Lower leg volume was measured by water displacement volumetry and limb circumference in nine women with marked Dependent Edema, but otherwise normal second or third trimester pregnancy, before and after upright water immersion exercise session (Aqua-Fit ® ) for 45 min. Maternal heart rate was monitored continuously throughout the session. Blood pressure was measured before and after the session. Results. Mean left leg volume decreased by 112 ml from 1665 to 1553 ml, and right leg volume by 84 ml from 1665 to 1581 ml ( P = 0.007). Cardiovascular parameters fluctuated within the normal range, well below the upper limits recommended in pregnancy. Conclusions. A single immersion exercise session is a safe, effective, and enjoyable complement, or alternative, to compression stockings for reduction of gestational Dependent Edema. Further study is required to determine its duration of...
Giancarlo Marenzi - One of the best experts on this subject based on the ideXlab platform.
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body fluid withdrawal with isolated ultrafiltration effects persistent improvement of functional capacity in patients with chronic congestive heart failure furosemide does not produce the same result
Cardiologia (Rome Italy), 1994Co-Authors: Giancarlo Marenzi, Paolo Sganzerla, Guilio Lauri, Giovanni B. Perego, Marco Guazzi, Piergiuseppe AgostoniAbstract:In moderate congestive heart failure pulmonary overhydration may be detected at chest X-ray even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of overhydration of the lung may help to define its significance. This study was aimed at investigating whether a subclinical accumulation of fluid in the lung interstitium in moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide is able to promote reabsorption of the excessive fluid. Patients whose digoxin, oral furosemide and ACE-inhibitor therapeutic regimen was kept constant, were randomly allocated to ultrafiltration (8 cases) or iv bolus (mean dose = 248 mg) of supplemental furosemide (8 cases). The amount of body fluid removed with each method approximated 1.600 ml. Functional performance was assessed with cardiopulmonary exercise tests. Soon after fluid withdrawal with either procedure the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine and aldosterone were augmented. After furosemide hormones remained elevated in the subsequent 4 days, and, during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, recurrence of lung congestion without any improvement in functional capacity. In ultrafiltrated patients, renin, norepinephrine and aldosterone fell below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). Functional capacity in these patients was improved through favorable circulatory and ventilatory adjustments consequent on reabsorption of lung water. This may also have restored the ability of the lung to clear norepinephrine, thus restraining its facilitation of renin release. Improvement persisted at 3 months after the procedure. In congestive heart failure the set point of fluid balance is altered despite oral furosemide; supplemental iv furosemide does not shift the set point, at least in the presence of ACE-inhibition; excessive, although silent, lung water limits the functional capacity of the patient.
-
sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency failure of furosemide to provide the same result
The American Journal of Medicine, 1994Co-Authors: Piergiuseppe Agostoni, Paolo Sganzerla, Giancarlo Marenzi, Gianfranco Lauri, Giovanbattista Perego, Maurizio Schianni, Marco GuazziAbstract:Abstract objectives: This study was designed to investigate whether a subclinical accumulation of fluid in the lung interstitium associated with moderate congestive heart failure interferes with the patient's functional capacity, and whether furosemide treatment can promote reabsorption of the excessive fluid. background: In patients with moderate congestive heart failure, pulmonary overhydration may be detected by chest roentgenography even if therapy is optimized to keep the urinary output normal and to prevent weight gain and Dependent Edema formation. Removal of the overhydration may help define its significance. methods: Patients, whose regimens of digoxin, oral furosemide, and angiotensin-converting enzyme (ACE) inhibitor therapy were kept constant, were randomly allocated to receive ultrafiltration (8 cases) or an intravenous bolus of supplemental furosemide (mean dose: 248 mg; 8 cases). The amount of body fluid removed with each method approximated 1600 mL. Functional performance was assessed with cardiopulmonary exercise tests. results: Soon after fluid withdrawal by either method, the filling pressures of the two ventricles and body weight were reduced and plasma renin activity, norepinephrine, and aldosterone were augmented. After furosemide administration, hormone levels remained elevated for the next 4 days, and during this period, patients had positive water metabolism, recovery of the elevated ventricular filling pressures, and reoccurrence of lung congestion with no improvement in functional capacity. After ultrafiltration, levels of renin, norepinephrine, and aldosterone fell to below control values within the first 48 hours and water metabolism was equilibrated at a new set point (less fluid intake and diuresis without weight gain). The favorable circulatory and ventilatory adjustments consequent to the reabsorption of lung water improved the functional capacity of these patients. That may also have restored the lung's ability to clear norepinephrine, thus restraining its facilitation of renin release. The improvement continued 3 months after the procedure. conclusions: In patients with congestive heart failure the set point of fluid balance is altered in spite of oral furosemide therapy; supplemental intravenous furosemide does not shift the set point, at least not when combined with ACE inhibition. Excessive, although asymptomatic, lung water limits the functional capacity of the patient.